NSG 4800 COMPS Exam – 2026/2027 Complete Edition – 77
Questions with Verified Correct Answers
Core Domains:
Professional Nursing Practice and Legal/Ethical Issues
Delegation, Prioritization, and Clinical Judgment
Pharmacology and Medication Administration
Fluid, Electrolyte, and Acid-Base Balance
Medical-Surgical Nursing (Cardiac, Respiratory, Neuro, Renal, GI)
Maternal-Newborn and Pediatric Nursing
Mental Health and Therapeutic Communication
Community Health and Care Coordination
Safety, Infection Control, and Emergency Preparedness
This comprehensive examination guide is designed to prepare students for the NSG
4800 Comprehensive Exit Exam at Galen College of Nursing. The exam covers
professional nursing practice, legal and ethical issues, delegation, prioritization,
pharmacology, medical-surgical nursing, maternal and pediatric care, mental
health, and community health concepts. Questions are structured to assess clinical
judgment, prioritization, and the application of nursing knowledge to real-world
patient scenarios. Each item includes a verified correct answer accompanied by a
detailed rationale to reinforce learning and support exam preparation for the
2026/2027 academic year.
SECTION ONE: QUESTIONS 1 – 77
Question 1
The nurse is assisting with discharge planning for assigned clients. Which referral
is appropriate for the nurse to make?
A. Social worker referral for a client who has diabetes mellitus (type 2) and
neuropathy
B. Physical therapy referral for a client who had a total knee replacement (TKR)
and needs instruction on the use of a walker
,C. Occupational therapy referral for a client who had an amputation and requires
long-term IV antibiotics
D. Speech therapy referral for a client who is scheduled to undergo an outpatient
esophagogastroduodenoscopy (EGD)
B. Physical therapy referral for a client who had a total knee replacement
(TKR) and needs instruction on the use of a walker
RATIONALE: Physical therapy is appropriate for clients requiring assistance
with mobility and ambulation devices after a total knee replacement. Social
workers address psychosocial and resource needs, occupational therapy addresses
activities of daily living, and speech therapy addresses swallowing and
communication disorders. A client scheduled for an EGD does not require speech
therapy .
Question 2
The nurse has attended a continuing education program on legal issues in nursing
practice. Which statement by the nurse indicates a correct understanding of the
conference?
A. "Failure to communicate concerns about an older adult client who is confused
and is being discharged home is an example of neglect."
B. "Giving clients false assurance about a health care condition or expected
outcome is an example of libel."
C. "Threatening to touch a client without the client's consent is an example of
battery."
D. "Posting information about a client on social media without the client's
permission is an example of slander."
A. "Failure to communicate concerns about an older adult client who is
confused and is being discharged home is an example of neglect."
RATIONALE: Neglect includes failure to communicate necessary client
concerns, especially safety issues such as discharging a confused older adult
without appropriate safeguards. Libel is written defamation; slander is spoken
defamation. Battery is actual harmful or offensive contact; assault is the threat of
such contact. Posting client information without permission is a HIPAA violation .
,Question 3
The nurse working in a medical-surgical unit is caring for assigned clients. Which
of the following tasks is appropriate to delegate?
A. Asking an unlicensed assistive personnel (UAP) to turn off the tube feeding for
a client who is receiving continuous tube feedings and is vomiting
B. Asking a licensed practical nurse (LPN/VN) to obtain a capillary blood glucose
reading on a client who has become diaphoretic
C. Asking an unlicensed assistive personnel (UAP) to flush the closed-wound
drainage system (JP) drain of a client who is 2 days postoperative from an open
appendectomy
D. Asking a licensed practical nurse (LPN/VN) to teach a client who has a newly
created ileostomy how to change the appliance
B. Asking a licensed practical nurse (LPN/VN) to obtain a capillary blood
glucose reading on a client who has become diaphoretic
RATIONALE: LPNs/LVNs can obtain capillary blood glucose readings, which
is within their scope of practice. UAPs cannot flush drains or turn off tube feedings
as these require nursing judgment. Teaching a client with a new ileostomy requires
RN-level assessment and education .
Question 4
The nurse working on the pediatric unit is caring for the following clients. It is
most appropriate for the nurse to initiate an interdisciplinary conference for a client
who is:
A. 7 months old, has intussusception, is vomiting, has colicky abdominal pain, and
is having jelly-like stools
B. 6 months old, has respiratory syncytial virus (RSV), is wheezing, and has
copious nasal discharge
C. 2 years old, has impaired fine and gross motor skills, and was just diagnosed
with cerebral palsy
D. 2 months old, has developmental dysplasia of the hip, unequal leg lengths,
internal abduction of the left hip, and asymmetry of the gluteal folds
, C. 2 years old, has impaired fine and gross motor skills, and was just diagnosed
with cerebral palsy
RATIONALE: A new diagnosis of cerebral palsy in a 2-year-old requires an
interdisciplinary conference involving physical therapy, occupational therapy,
speech therapy, social work, and developmental specialists to coordinate care. The
other clients require medical management but not necessarily interdisciplinary
conference .
Question 5
The nurse working on the medical-surgical unit is caring for assigned clients. The
nurse should initially assess the client who:
A. Has pericarditis with a temperature of 101.8°F and chest pain that is relieved
when the client leans forward
B. Has atrial fibrillation with a pulse that varies from 110 to 140 and is refusing to
take the scheduled dose of warfarin
C. Has status asthmaticus, had wheezing on inspiration and expiration upon
admission 30 minutes ago, received a nebulizer treatment, and now has vesicular
breath sounds
D. Had thoracic surgery 12 hours ago with a chest tube to water seal drainage and
has drained 175 mL of serous sanguineous fluid in the past hour
C. Has status asthmaticus, had wheezing on inspiration and expiration upon
admission 30 minutes ago, received a nebulizer treatment, and now has vesicular
breath sounds
RATIONALE: A client with status asthmaticus who now has vesicular breath
sounds after treatment requires immediate reassessment. Vesicular breath sounds
may indicate improvement, but the nurse must assess for continued bronchospasm
or worsening respiratory status. Clients with pericarditis, atrial fibrillation, and
post-thoracic surgery are stable .
Question 6
Questions with Verified Correct Answers
Core Domains:
Professional Nursing Practice and Legal/Ethical Issues
Delegation, Prioritization, and Clinical Judgment
Pharmacology and Medication Administration
Fluid, Electrolyte, and Acid-Base Balance
Medical-Surgical Nursing (Cardiac, Respiratory, Neuro, Renal, GI)
Maternal-Newborn and Pediatric Nursing
Mental Health and Therapeutic Communication
Community Health and Care Coordination
Safety, Infection Control, and Emergency Preparedness
This comprehensive examination guide is designed to prepare students for the NSG
4800 Comprehensive Exit Exam at Galen College of Nursing. The exam covers
professional nursing practice, legal and ethical issues, delegation, prioritization,
pharmacology, medical-surgical nursing, maternal and pediatric care, mental
health, and community health concepts. Questions are structured to assess clinical
judgment, prioritization, and the application of nursing knowledge to real-world
patient scenarios. Each item includes a verified correct answer accompanied by a
detailed rationale to reinforce learning and support exam preparation for the
2026/2027 academic year.
SECTION ONE: QUESTIONS 1 – 77
Question 1
The nurse is assisting with discharge planning for assigned clients. Which referral
is appropriate for the nurse to make?
A. Social worker referral for a client who has diabetes mellitus (type 2) and
neuropathy
B. Physical therapy referral for a client who had a total knee replacement (TKR)
and needs instruction on the use of a walker
,C. Occupational therapy referral for a client who had an amputation and requires
long-term IV antibiotics
D. Speech therapy referral for a client who is scheduled to undergo an outpatient
esophagogastroduodenoscopy (EGD)
B. Physical therapy referral for a client who had a total knee replacement
(TKR) and needs instruction on the use of a walker
RATIONALE: Physical therapy is appropriate for clients requiring assistance
with mobility and ambulation devices after a total knee replacement. Social
workers address psychosocial and resource needs, occupational therapy addresses
activities of daily living, and speech therapy addresses swallowing and
communication disorders. A client scheduled for an EGD does not require speech
therapy .
Question 2
The nurse has attended a continuing education program on legal issues in nursing
practice. Which statement by the nurse indicates a correct understanding of the
conference?
A. "Failure to communicate concerns about an older adult client who is confused
and is being discharged home is an example of neglect."
B. "Giving clients false assurance about a health care condition or expected
outcome is an example of libel."
C. "Threatening to touch a client without the client's consent is an example of
battery."
D. "Posting information about a client on social media without the client's
permission is an example of slander."
A. "Failure to communicate concerns about an older adult client who is
confused and is being discharged home is an example of neglect."
RATIONALE: Neglect includes failure to communicate necessary client
concerns, especially safety issues such as discharging a confused older adult
without appropriate safeguards. Libel is written defamation; slander is spoken
defamation. Battery is actual harmful or offensive contact; assault is the threat of
such contact. Posting client information without permission is a HIPAA violation .
,Question 3
The nurse working in a medical-surgical unit is caring for assigned clients. Which
of the following tasks is appropriate to delegate?
A. Asking an unlicensed assistive personnel (UAP) to turn off the tube feeding for
a client who is receiving continuous tube feedings and is vomiting
B. Asking a licensed practical nurse (LPN/VN) to obtain a capillary blood glucose
reading on a client who has become diaphoretic
C. Asking an unlicensed assistive personnel (UAP) to flush the closed-wound
drainage system (JP) drain of a client who is 2 days postoperative from an open
appendectomy
D. Asking a licensed practical nurse (LPN/VN) to teach a client who has a newly
created ileostomy how to change the appliance
B. Asking a licensed practical nurse (LPN/VN) to obtain a capillary blood
glucose reading on a client who has become diaphoretic
RATIONALE: LPNs/LVNs can obtain capillary blood glucose readings, which
is within their scope of practice. UAPs cannot flush drains or turn off tube feedings
as these require nursing judgment. Teaching a client with a new ileostomy requires
RN-level assessment and education .
Question 4
The nurse working on the pediatric unit is caring for the following clients. It is
most appropriate for the nurse to initiate an interdisciplinary conference for a client
who is:
A. 7 months old, has intussusception, is vomiting, has colicky abdominal pain, and
is having jelly-like stools
B. 6 months old, has respiratory syncytial virus (RSV), is wheezing, and has
copious nasal discharge
C. 2 years old, has impaired fine and gross motor skills, and was just diagnosed
with cerebral palsy
D. 2 months old, has developmental dysplasia of the hip, unequal leg lengths,
internal abduction of the left hip, and asymmetry of the gluteal folds
, C. 2 years old, has impaired fine and gross motor skills, and was just diagnosed
with cerebral palsy
RATIONALE: A new diagnosis of cerebral palsy in a 2-year-old requires an
interdisciplinary conference involving physical therapy, occupational therapy,
speech therapy, social work, and developmental specialists to coordinate care. The
other clients require medical management but not necessarily interdisciplinary
conference .
Question 5
The nurse working on the medical-surgical unit is caring for assigned clients. The
nurse should initially assess the client who:
A. Has pericarditis with a temperature of 101.8°F and chest pain that is relieved
when the client leans forward
B. Has atrial fibrillation with a pulse that varies from 110 to 140 and is refusing to
take the scheduled dose of warfarin
C. Has status asthmaticus, had wheezing on inspiration and expiration upon
admission 30 minutes ago, received a nebulizer treatment, and now has vesicular
breath sounds
D. Had thoracic surgery 12 hours ago with a chest tube to water seal drainage and
has drained 175 mL of serous sanguineous fluid in the past hour
C. Has status asthmaticus, had wheezing on inspiration and expiration upon
admission 30 minutes ago, received a nebulizer treatment, and now has vesicular
breath sounds
RATIONALE: A client with status asthmaticus who now has vesicular breath
sounds after treatment requires immediate reassessment. Vesicular breath sounds
may indicate improvement, but the nurse must assess for continued bronchospasm
or worsening respiratory status. Clients with pericarditis, atrial fibrillation, and
post-thoracic surgery are stable .
Question 6
